The future is your insurance company making you wear a smart watch 24/7 if you don’t want to pay a huge premium. I predict it’s going to be a huge quagmire over the next decade or so.

It would be a huge invasion of privacy for an insurance company to do this - and not only privacy, but the fact that insurance companies can discriminate based on this data means that the healthy don't end up subsidising the unhealthy (which is the whole point of insurance). SO premiums go up regardless, and only the insurance company win in this scenario.

Right now, the right choice is to combat this problem before it becomes a real problem. Before it sets root as cultrually acceptable to hand over your biometrics data to private companies without the right payment and compensation.

> but the fact that insurance companies can discriminate based on this data means that the healthy don't end up subsidising the unhealthy (which is the whole point of insurance).

I agree with your premise about the point of insurance. How is the discussed idea any different than insurance companies giving different rates to older people and denying coverage for pre existing conditions, in terms of discrimination against the non healthy?

It’s not different, but denying coverage for pre existing conditions is illegal in the US. Also, there is a limit to the ratio between the highest premium and lowest premium in the insurance pool, along with out of pocket maximums so you will still end up with the healthy subsidizing the unhealthy.

Incentives to make people healthier should not be a problem with these constraints (max premium rations and guaranteed coverage for everyone). It’s no different than offering a lower car insurance premium to someone that doesn’t drive drunk.

These are so American problems... It already reads like a dystopia.

I completely agree with your sentiment. Sadly given the state of privacy, healthcare, lobbying, etc in the US, it is something I am very worried about.

Insurance companies are already doing this. My friend gets $5 discount on his monthly premium for wearing a garmin wristband.

It'll probably be more like auto insurance companies where they offer a voluntary tracking program and if you're better than average you get a discount

We're already headed in that direction, for sure. The company I currently work for doesn't run a program through the insurance company directly, but they do make the company contribution to your HSA dependent on you participating in their wellness program. Bonus points if you have a smartwatch that can feed data back. Supposedly none of that info gets back to the company or insurance, but I wouldn't bet on it.

The health insurers have been relatively "smart" (more accurately, subtle) about this by this separation of the tracking/privacy implications into separate "Wellness" programs. In many cases these Wellness programs do seem to be firewalled from insurers with the only information passing between Wellness and Insurance being the simple abstracted metrics of "Level" or "Points", and that by way of presumably only the Benefits coordination aspects of corporate HR.

Though there are still questions of how strong the firewall is in cases where the Wellness programs and Insurance providers share parent companies or even just C-Suite members. Arguably, the separation allows corporate plan buyers to pick and choose Insurance and Wellness program separately, allowing for some competition between them on things like privacy. Yet, being employer-driven "benefits" first and foremost, it's hard to say how much the end consumer/user/employer's privacy is always prioritized, as it is an indirect need of the market.

(Also, every employer I've seen the Wellness program didn't define HSA contributions but rather "discounts" on Insurance premiums, which does seem to indicate that Insurance companies are probably using the Wellness program for risk pools, even with what little data they supposedly are being fed across the firewalls.)

The real issue is how this is implemented. Will they just require that you wear the watch (and act on the data when it shows you have an issue), or share all the health data collected with the insurer?

I can see a future where Apple charges your doctor 30% of her fees for access to the heart data in their walled garden

It's already happening. Some insurers are giving lower rates to people who wear this stuff and allows the insurer to see the data for better pricing premiums for each individual. I also had purchased stock in a small cap company that makes tech to allow telemedicine to be possible.